How do I enroll my eligible dependents?
Complete and submit the Healthcare Coverage Enrollment Form and provide required documentation (see table below) within 90 days of your initial eligibility date. As your career progresses, if you get married, have a new baby, adopt a child or have a child placed with you for adoption, you must submit required documentation and complete a new Healthcare Coverage Enrollment Form within 90 days of the event.
Required Documentation for Enrolling Dependents
|
Dependent Type |
| Acceptable Proof of Dependent Status |
Spouse |
Child |
Child
(with court ordered coverage) |
Newly Adopted Child |
Stepchild |
| Original County-certified marriage certificate1 |
YES |
|
|
|
|
| Original County-certified birth certificate |
|
YES |
YES |
|
YES |
| Qualified Medical Child Support Order (QMCSO)2 or a National Medical Support Notice |
|
|
YES |
|
|
| Original county-certified divorce decree (if the parents are divorced) |
|
|
YES |
|
YES3 |
| Interim order of placement and/or final adoption order |
|
|
|
YES |
|
Document requirements change from time to time.
1Church marriage certificates and Hospital birth announcements are not acceptable forms of proof.
2Click here for the Plan's QMCSO procedures
3A stepchild dependent affidavit or a death certificate of the biological parent is also acceptable